scholarly journals Age at entry to UK military service and long-term mental health

2021 ◽  
pp. bmjmilitary-2021-001786
Author(s):  
Beverly P Bergman ◽  
DF Mackay ◽  
NT Fear ◽  
JP Pell
Keyword(s):  
Mental Health ◽  
Health Outcomes ◽  
Military Service ◽  
Armed Forces ◽  
Mental Health Disorder ◽  
Mental Health Outcomes ◽  
Birth Cohorts ◽  
Increased Risk ◽  
The Uk

IntroductionIt has been suggested that ‘junior entry’ to the UK Armed Forces (prior to age 17.5 years) increases the risk of adverse mental health outcomes. We used data from a large cohort of veterans to examine long-term mental health outcomes in veterans by age at entry to the UK Armed Forces, compared with non-veterans.MethodsRetrospective cohort study of 78 157 veterans in Scotland, born between 1945 and 1995 and and 252 637 matched non-veterans, with up to 37 years follow-up, using Cox proportional hazard models to examine the association between veteran status and cumulative risk of major mental health disorder, stratified by birth cohort, and age at recruitment for the veterans.ResultsThe risk of mental health disorder in the veterans increased with age at entry, ranging from HR 1.12, 95% CI 1.06 to 1.18, p<0.001 for junior entrants to HR 1.37, 95% CI 1.27 to 1.80, p<0.001 for those aged 20–25 years at entry. The pattern was most marked for veterans born before 1960, and age at recruitment had little impact in recent birth cohorts. Post-traumatic stress disorder accounted for most of the observed differences. Younger age at recruitment was associated with longer service, median 7.4 years (IQR 3.0–14.7) compared with 5.6 years (IQR 2.1–11.7) for entrants aged 20–25 years.ConclusionWe found no evidence that early recruitment is associated with adverse impact on long-term mental health. Paradoxically, it was veterans who entered service at age 20–25 years who demonstrated increased risk, although this attenuated in more recent birth cohorts.

Incidence and Predictors of Mental Health Outcomes Among Survivors of Adolescent and Young Adult Cancer: A Population-Based Study Using the IMPACT Cohort

2021 ◽  
pp. JCO.20.02019
Author(s):  
Riddhita De ◽  
Rinku Sutradhar ◽  
Paul Kurdyak ◽  
Suriya Aktar ◽  
Jason D. Pole ◽  
...  
Keyword(s):  
Mental Health ◽  
Young Adult ◽  
Health Outcomes ◽  
Psychotic Disorder ◽  
Population Based ◽  
Mental Health Outcomes ◽  
Adolescent And Young Adult ◽  
Increased Risk ◽  
The Impact

PURPOSE Risk and predictors of long-term mental health outcomes in survivors of adolescent and young adult (AYA) cancers are poorly characterized. Mental health is consequently neglected in long-term follow-up. METHODS We identified all AYA in Ontario, Canada age 15-21 years when diagnosed with one of six common cancers between 1992-2012 using a population-based database, and compared them with matched controls. Linkage to provincial healthcare data allowed analysis of rates of outpatient (family physician and psychiatrist) visits for psychiatric indications and time to severe psychiatric events (emergency room visit, hospitalization, and suicide). Demographic-, disease-, and treatment-related predictors of adverse outcomes, including treatment setting (adult v pediatric), were examined. RESULTS Among 2,208 survivors and 10,457 matched controls, 5-year survivors experienced higher rates of outpatient mental health visits than controls (671 visits per 1,000 person-years v 506; adjusted rate ratio [RR] 1.3; 95% CI, 1.1 to 1.5; P = .006). Risk of a severe psychiatric episode was also increased among survivors (adjusted hazard ratio [HR], 1.2; 95% CI, 1.1 to 1.4, P = .008). Risk of a psychotic disorder–associated severe event was doubled in survivors (HR, 2.0, 95% CI, 1.3 to 2.4; P = .007) although absolute risk remained low (15-year cumulative incidence 1.7%; 95% CI, 1.0 to 2.7). In multivariable analysis, survivors treated in adult centers experienced substantially higher outpatient visit rates compared with those treated in pediatric settings (RR 1.8; 95% CI, 1.0 to 3.1; P = .04). CONCLUSION Survivors of AYA cancer are at substantially increased risk of adverse mental health outcomes, with those treated in adult centers at particular risk. Although absolute incidence was low, survivors were at increased risk of psychotic disorder–associated severe events. Long-term mental health surveillance is warranted, as is research into effective interventions during or after cancer treatment.

scholarly journals Mental health outcomes at the end of the British involvement in the Iraq and Afghanistan conflicts: a cohort study

2018 ◽  
Vol 213 (6) ◽  
pp. 690-697 ◽  
Author(s):  
Sharon A. M. Stevelink ◽  
Margaret Jones ◽  
Lisa Hull ◽  
David Pernet ◽  
Shirlee MacCrimmon ◽  
...  
Keyword(s):  
Mental Health ◽  
Health Outcomes ◽  
Traumatic Stress ◽  
Alcohol Misuse ◽  
Armed Forces ◽  
Mental Health Outcomes ◽  
Post Traumatic Stress ◽  
King's College ◽  
Post Traumatic ◽  
The Uk

BackgroundLittle is known about the prevalence of mental health outcomes in UK personnel at the end of the British involvement in the Iraq and Afghanistan conflicts.AimsWe examined the prevalence of mental disorders and alcohol misuse, whether this differed between serving and ex-serving regular personnel and by deployment status.MethodThis is the third phase of a military cohort study (2014–2016; n = 8093). The sample was based on participants from previous phases (2004–2006 and 2007–2009) and a new randomly selected sample of those who had joined the UK armed forces since 2009.ResultsThe prevalence was 6.2% for probable post-traumatic stress disorder, 21.9% for common mental disorders and 10.0% for alcohol misuse. Deployment to Iraq or Afghanistan and a combat role during deployment were associated with significantly worse mental health outcomes and alcohol misuse in ex-serving regular personnel but not in currently serving regular personnel.ConclusionsThe findings highlight an increasing prevalence of post-traumatic stress disorder and a lowering prevalence of alcohol misuse compared with our previous findings and stresses the importance of continued surveillance during service and beyond.Declaration of interest:All authors are based at King's College London which, for the purpose of this study and other military-related studies, receives funding from the UK Ministry of Defence (MoD). S.A.M.S., M.J., L.H., D.P., S.M. and R.J.R. salaries were totally or partially paid by the UK MoD. The UK MoD provides support to the Academic Department of Military Mental Health, and the salaries of N.J., N.G. and N.T.F. are covered totally or partly by this contribution. D.Mu. is employed by Combat Stress, a national UK charity that provides clinical mental health services to veterans. D.MacM. is the lead consultant for an NHS Veteran Mental Health Service. N.G. is the Royal College of Psychiatrists’ Lead for Military and Veterans’ Health, a trustee of Walking with the Wounded, and an independent director at the Forces in Mind Trust; however, he was not directed by these organisations in any way in relation to his contribution to this paper. N.J. is a full-time member of the armed forces seconded to King's College London. N.T.F. reports grants from the US Department of Defense and the UK MoD, is a trustee (unpaid) of The Warrior Programme and an independent advisor to the Independent Group Advising on the Release of Data (IGARD). S.W. is a trustee (unpaid) of Combat Stress and Honorary Civilian Consultant Advisor in Psychiatry for the British Army (unpaid). S.W. is affiliated to the National Institute for Health Research Health Protection Research Unit (NIHR HPRU) in Emergency Preparedness and Response at King's College London in partnership with Public Health England, in collaboration with the University of East Anglia and Newcastle University. The views expressed are those of the author(s) and not necessarily those of the National Health Service, the NIHR, the Department of Health, Public Health England or the UK MoD.

scholarly journals Mental health in the UK during the COVID-19 pandemic: early observations

2020 ◽  
Author(s):  
Ru Jia ◽  
Kieran Ayling ◽  
Trudie Chalder ◽  
Adam Massey ◽  
Elizabeth Broadbent ◽  
...  
Keyword(s):  
Mental Health ◽  
Health Outcomes ◽  
Online Survey ◽  
Positive Mood ◽  
Mental Health Outcomes ◽  
Explanatory Factors ◽  
Increased Risk ◽  
Modifiable Factors ◽  
Multivariable Models ◽  
The Uk

Background: Previous pandemics have resulted in significant consequences for mental health. Here we report the mental health sequela of the COVID-19 pandemic on the UK population and examine modifiable and non-modifiable explanatory factors associated with mental health outcomes. We focus on the short-term consequences for mental health, as reported during the first four-six weeks of social distancing measures being introduced. Methods: A community cohort study was conducted with adults aged ≥18 years recruited through a mainstream and social media campaign between 3/4/20-30/4/20. Consenting participants completed an online survey measuring depression, anxiety and stress and explanatory variables hypothesised to be related to these mental health outcomes. Outcomes: N=3097 eligible individuals participated. The cohort was predominantly female (85%); mean age forty-four years; 10% from minority ethnic groups; 50% described themselves as key-workers and 20% identified as having clinical risk factors putting them at increased risk of COVID-19. Mean scores for depression, stress and anxiety significantly exceeded population norms. Analysis of non-modifiable factors indicated that being younger and female were associated with all outcomes, with the final multivariable models accounting for 7-13% of variance. When adding modifiable factors, significant independent effects emerged for positive mood, perceived loneliness and worry about getting COVID-19 for all outcomes, with the final multivariable models accounting for 54-57% of variance. Interpretation: Increased psychological morbidity was evident in this UK cohort, with younger people and women at particular risk. Interventions targeting perceptions of: loneliness, risk of COVID-19, worry about COVID-19, and positive mood may be effective.

scholarly journals Long-Term Mental Health Outcomes of Military Service

2016 ◽  
Vol 77 (06) ◽  
pp. 793-798 ◽  
Author(s):  
Beverly P. Bergman ◽  
Daniel F. Mackay ◽  
Daniel J. Smith ◽  
Jill P. Pell
Keyword(s):  
Mental Health ◽  
Health Outcomes ◽  
Military Service ◽  
Mental Health Outcomes

Motoric Subtypes of Delirium and Long-Term Functional and Mental Health Outcomes in Adults After Critical Illness

2021 ◽  
Vol 49 (5) ◽  
pp. e521-e532
Author(s):  
Kimberly F. Rengel ◽  
Christina J. Hayhurst ◽  
James C. Jackson ◽  
Christina S. Boncyk ◽  
Mayur B. Patel ◽  
...  
Keyword(s):  
Mental Health ◽  
Critical Illness ◽  
Health Outcomes ◽  
Mental Health Outcomes

scholarly journals Reframing political violence and mental health outcomes: outlining a research and action agenda for Latin America and the Caribbean region

2006 ◽  
Vol 11 (2) ◽  
pp. 293-302 ◽  
Author(s):  
Duncan Pedersen
Keyword(s):  
Mental Health ◽  
Health Outcomes ◽  
Political Violence ◽  
Latin American ◽  
Mental Health Outcomes ◽  
Guerrilla Warfare ◽  
Caribbean Region ◽  
Post Conflict ◽  
Forms Of Violence

In recent decades, the number of people exposed to traumatic events has significantly increased as various forms of violence, including war and political upheaval, engulf civilian populations worldwide. In spite of widespread armed conflict, guerrilla warfare and political violence in the Latin American and Caribbean region, insufficient attention had been paid in assessing the medium and long-term psychological impact and additional burden of disease, death, and disability caused by violence and wars amongst civilian populations. Following a review of the literature, a few central questions are raised: What is the short, medium and long-term health impact of extreme and sustained forms of violence in a given population? How political violence is linked to poor mental health outcomes at the individual and collective levels? Are trauma-related disorders, universal outcomes of extreme and sustained violence? These questions lead us to reframe the analysis of political violence and mental health outcomes, and reexamine the notions of trauma, after which a research and action agenda for the region is outlined. In the concluding sections, some basic principles that may prove useful when designing psychosocial interventions in post-conflict situations are reviewed.

scholarly journals Social services Interventions and the Mental Health and Mortality of care leavers: a population based data linkage study in Northern Ireland and Finland

2019 ◽  
Vol 4 (3) ◽  
Author(s):  
Aideen Maguire ◽  
Anne Kouvonen ◽  
Dermot O'Reilly ◽  
Hanna Remes ◽  
Joonas Pitkänen ◽  
...  
Keyword(s):  
Mental Health ◽  
Northern Ireland ◽  
Health Outcomes ◽  
Social Services ◽  
Psychiatric Hospital ◽  
Poor Mental Health ◽  
Mental Health Outcomes ◽  
Care Intervention ◽  
Increased Risk ◽  
Self Harm

BackgroundResearch has highlighted the poor mental health of looked after children compared to those never in care. However, little is known on what becomes of these children and their mental health trajectories after they leave the care of social services. In addition, previous studies are limited in their ability to differentiate between type of social care intervention received; kinship care, foster care or residential care. AimTo utilise nationwide social services data from two countries (Northern Ireland (NI) and Finland), with similar populations but different intervention policies, linked to a range of demographic and health datasets to examine the mental health outcomes of young adults in the years following leaving care. MethodsData from both countries on children born 1991-2000 were linked to social services data, hospital admissions, prescribed medication data and death records. Mental health outcomes were defined after the age of 18years (when statutory care provision ends) examined by care intervention and included admissions to psychiatric hospital, for self-harm and death by suicide. ResultsThe gender split in care in Finland is reflective of the population but more males are in care in NI. Initial results from Finnish data suggest those exposed to care in childhood have an increased risk of self-harm, psychiatric hospital admission and suicide after the age of 18years compared to those never in care. After adjusting for gender, age of entry to care and deprivation at birth those exposed to any care intervention had 3 times the risk of suicide (HR=3.06, 95% CI 1.18,7.98). Risk increased with duration in care but was equivalent across care intervention types. Analysis on the NI data is underway. ConclusionFull results will be available December 2019 and will explore which care pathways are most associated with poor mental health outcomes informing discussion around intervention opportunities and policy.

Cognitive, physical, and mental health outcomes between long-term cannabis and tobacco users

2018 ◽  
Vol 79 ◽  
pp. 178-188 ◽  
Author(s):  
M.E. Lovell ◽  
R. Bruno ◽  
J. Johnston ◽  
A. Matthews ◽  
I. McGregor ◽  
...  
Keyword(s):  
Mental Health ◽  
Health Outcomes ◽  
Mental Health Outcomes ◽  
Physical And Mental Health

Contribution of mental ill health during military service to postservice benefit claims in the UK

2021 ◽  
pp. oemed-2020-107050
Author(s):  
Howard Burdett ◽  
Nicola T Fear ◽  
Simon Wessely ◽  
Neil Greenberg ◽  
Roberto J Rona
Keyword(s):  
Mental Health ◽  
Military Service ◽  
Mental Health Problems ◽  
Common Mental Disorder ◽  
Population Attributable Fraction ◽  
Armed Forces ◽  
Post Traumatic Stress ◽  
Civilian Life ◽  
Carry Over ◽  
The Uk

ObjectivesWhile most UK military personnel transition successfully into civilian life, some experience unemployment and disability, which may be partly attributable to in-service factors. This study aims to determine the degree to which in-service mental health problems impact on postservice benefit claims.MethodsUsing data from a cohort of 5598 recent leavers from regular service in the UK Armed Forces linked with data from the Department for Work and Pensions, we assessed associations between in-service mental health and postservice benefit claims, and the population attributable fraction (PAF) of benefit claims related to in-service mental health. An analysis with postservice mental ill health as mediator was performed to determine the degree to which the observed effects were a consequence of persistent illness, as opposed to remitted.ResultsMental illness occurring in-service predicted both unemployment and disability claims, partly mediated by postservice health (23%–52% total effects mediated), but alcohol misuse did not. Common mental disorder (CMD) (PAF 0.07, 95% CI: 0.02 to 0.11) and probable post-traumatic stress disorder (PTSD) (PAF 0.05, 95% CI 0.01 to 0.09) contributed to unemployment claims. Probable PTSD was the largest contributor to disability claims (PAF 0.25, 95% CI 0.13 to 0.36), with a smaller contribution from CMD (PAF 0.16, 95% CI 0.03 to 0.27).ConclusionsIn-service mental ill health gives rise to benefit claims. These effects are only partly mediated by postservice mental health, implying that in-service (or pre-service) mental issues have carry-over effects into civilian life even if remitted. Better prevention and treatment of in-service PTSD symptoms may well reduce postservice disability claims.

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